Résumé
Les portages de repas à domicile sont de plus en plus utilisés par les personnes âgées. Ce sont surtout des personnes seules ou de vieux couples qui s’en servent, très souvent parce qu’ils ont des difficultés à faire leurs courses ou à cuisiner (50 %), plus rarement au décours d’une hospitalisation (un tiers des cas). Elles utilisent ce service parfois sur plusieurs années. Elles reçoivent presque toujours un repas par jour, souvent avec une soupe en plus pour le repas du soir. Si les clients sont globalement satisfaits du service, ils expriment de nombreuses critiques: plats pas toujours adaptés à leurs goûts, manque de choix, difficultés à changer un plat, certains produits trop durs (viande, légumes), peu de contact avec les livreurs, prix parfois trop chers…Ces repas ne sont pas toujours consommés en entier et servent souvent aussi pour le repas du soir. Si l’on connaît le vécu des bénéficiaires, on ignore l’apport de ces repas en termes d’énergie ou de nutriments. En effet, très peu d’enquêtes sur ces services ont été conduites, tant en France qu’ailleurs. Ainsi, l’utilité de ces services en termes de prévention de la dénutrition chez les patients à risque est aujourd’hui inconnue. De même, le faible temps consacré à la livraison fait que ces services ne peuvent pas être aujourd’hui utilisés comme facteur de surveillance (donc de prévention) d’une éventuelle dégradation de l’état de santé au domicile. Il devient donc important qu’une réglementation concernant ces services puisse être élaborée pour s’assurer de leur utilité sur la préservation des états nutritionnels et de santé au domicile.
Abstract
Meals on Wheels are increasingly used by home-living elderly people. Users are mostly lonely people and old couples. They are using it generally for shopping and/or cooking difficulties (50%), less frequently after an hospitalization period (1/3), sometimes for years. Usually the service offers one meal a day, often with an extra soup for dinner. Customers estimate the offer as good even though they express numerous criticisms: dishes not in relation to their own tastes, little choices and problems to obtain dish changes, too though dish (meat and vegetable), few contacts with delivering persons and too high costs. They do not always eat all served meals at lunch, using part of it for dinner. User’s opinions have been inquired, in contrast, energy and nutrient served are unknown, since few studies have been conducted in France and elsewhere. Undernutrition prevention in at-risk individuals remains to be evaluated. In addition, usefulness of such services for health status slow deterioration prevention has still to be proved since delivering persons do not have time to do it. In consequences, it may be urgent that specific rules are taken in order those services take part in prevention for home living elderly.
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Lesourd, B., Dadet, S. Portage de repas à domicile : quel rôle et quelle efficacité ?. cah. année gerontol. 5, 318–325 (2013). https://doi.org/10.1007/s12612-013-0364-4
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DOI: https://doi.org/10.1007/s12612-013-0364-4